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ATTACHMENT E
<br /> CERTIFICATION OF COMPLIANCE WITH THE STATUTORY ELIGIBILITY REQUIREMENTS OF THE VIOLENCE
<br /> AGAINST WOMEN ACT AS AMENDED,STOP FORMULA GRANT PROGRAM
<br /> NOTE: If the applicant is a community-based victim service provider with criminal justice agencies receiving STOP
<br /> Grant funds through their grant, one of the criminal justice agencies must complete this form to be submitted by
<br /> the victim service applicant.
<br /> Applicants should refer to the laws cited below forfurther information regarding the certifications to which they are required
<br /> to attest. Signature on this form certifies that the Applicant is qualified to receive the STOP Formula Grant Program funds
<br /> and is in compliance with relevant requirements under 34 U.S.0§§10441,10446 through 10451 and 28 C.F.R.Part 90. These
<br /> certifications shall be treated as a material representation of fact upon which the Department will rely if it determines to
<br /> award the covered transaction,grant,or cooperative agreement. Any federal funds received under this subchapter will
<br /> be used to supplement, not supplant, nonfederal funds that would otherwise be available for activities funded
<br /> under this chapter.
<br /> In addition,to be eligible for funding under the STOP Formula Grant Program, applicants must certify compliance
<br /> with the requirements in 34 U.S.C. §§ 10449, 10450, and 10451 and implemented at 28 C.F.R. Part 90,as follows:
<br /> (1)Forensic Medical Examination Payment Requirement for Victims of Sexual Assault
<br /> (a)A state,Indian tribal government,or unit of local government shall not be entitled to funds under the STOP Formula Grant
<br /> Program unless the state,Indian tribal government,unit of local government,or another governmental entity—
<br /> (1) incurs the full out-of-pocket cost of forensic medical exams for victims of sexual assault;and
<br /> (2) coordinates with health care providers in the region to notify victims of sexual assault of the availability of rape
<br /> exams at no cost to the victims.
<br /> (b)A state, Indian tribal government, or unit of local government shall be deemed to incur the full out-of-pocket cost of
<br /> forensic medical exams for victims of sexual assault if any government entity:
<br /> (1) provides such exams to victims free of charge to the victim;or
<br /> (2) arranges for victims to obtain such exams free of charge to the victims.
<br /> (c) A state or Indian tribal government may use STOP Formula Grant Program funds to pay for forensic medical exams
<br /> performed by trained examiners for victims of sexual assault, except that such funds may not be used to pay for forensic
<br /> medical exams by any state or Indian tribal government that requires victims of sexual assault to seek reimbursement for
<br /> such exams from their insurance carriers.
<br /> (d)To be in compliance with this section, a state, Indian tribal government, or unit of local government shall com
<br /> ply with subsection (b) without regard to whether the victim participates in the criminal justice system or cooper
<br /> ates with law enforcement.
<br /> (2)Filing Costs For Criminal Charges and Protection Orders
<br /> A state, Indian tribal government,or unit of local government will not be entitled to funds under the STOP Formula Grant
<br /> Program unless it certifies that its laws, policies, and practices do not require, in connection with the prosecution of any
<br /> misdemeanor or felony sexual assault,domestic violence,dating violence,or stalking offense,or in connection with the filing,
<br /> issuance, registration, modification,enforcement,dismissal,withdrawal or service of a protection order,or a petition for a
<br /> protection order,to protect a victim of sexual assault,domestic violence,dating violence,or stalking,that the victim bear the
<br /> costs associated with the filing of criminal charges against the offender, or the costs associated with the filing, issuance,
<br /> registration, modification, enforcement, dismissal, withdrawal or service of a warrant, protection order, petition for a
<br /> protection order,or witness subpoena,whether issued inside or outside the State,tribal,or local jurisdiction.
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